| Alpha Counseling Services Pllc. | |
|
15050 Ederberry Lane Suite 6 Fort Myers FL 33907 | |
| (239) 214-3822 | |
| (239) 214-3822 |
| Full Name | Alpha Counseling Services Pllc. |
|---|---|
| Speciality | Counselor |
| Location | 15050 Ederberry Lane Suite 6, Fort Myers, Florida |
| Authorized Official Name and Position | Johnnie Terrell (CEO/ PROVIDER) |
| Authorized Official Contact | 2392143822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Counseling Services Pllc. 15050 Ederberry Lane Suite 6 15050 Elderberry Lane Suite 6 Fort Myers FL 33907 Ph: (239) 214-3822 | Alpha Counseling Services Pllc. 15050 Ederberry Lane Suite 6 Fort Myers FL 33907 Ph: (239) 214-3822 |
| NPI Number | 1174243679 |
|---|---|
| Provider Enumeration Date | 09/02/2022 |
| Last Update Date | 06/06/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 9234597857 |
|---|---|
| Medicare Enrollment ID | O20230614000817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174243679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Johnnie Terrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710411467 PECOS PAC ID: 3870951494 Enrollment ID: I20230614001055 |
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